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Non-bacterial thrombotic endocarditis: clinicopathologic correlations

L M Deppisch, A O Fayemi

    American Heart Journal
    |December 1, 1976
    PubMed
    Summary
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    Nonbacterial thrombotic endocarditis (NBTE) affects 1.6% of adult autopsies. Malignant neoplasms, particularly adenocarcinoma, are frequently associated with NBTE, suggesting a link to coagulation disorders like disseminated intravascular coagulation (DIC).

    Area of Science:

    • Cardiovascular Pathology
    • Oncology
    • Hematology

    Background:

    • Nonbacterial thrombotic endocarditis (NBTE) is a rare condition characterized by sterile vegetations on heart valves.
    • Its association with underlying systemic diseases, particularly malignancy, is recognized but not fully elucidated.

    Purpose of the Study:

    • To determine the incidence of NBTE in an autopsy population.
    • To investigate the association between NBTE and malignant neoplasms.
    • To explore potential underlying mechanisms, such as coagulation abnormalities.

    Main Methods:

    • Retrospective autopsy study over a 10-year period.
    • Analysis of 65 NBTE cases within the adult autopsy population.
    • Review of associated medical conditions, focusing on neoplasms and coagulation status.

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    Main Results:

    • NBTE was found in 1.6% of adult autopsies.
    • Malignant neoplasms were associated with 51 of the 65 NBTE cases, with adenocarcinoma being the most common type.
    • Coagulation abnormalities suggestive of disseminated intravascular coagulation (DIC) were present in 18.5% of cases.

    Conclusions:

    • NBTE is significantly associated with underlying malignancy, especially adenocarcinoma.
    • Disseminated intravascular coagulation (DIC) may play a role in the pathogenesis of NBTE and its associated thrombotic events.
    • NBTE can lead to significant arterial thrombosis and infarction in various organs, with cerebral and cardiac complications being the most critical.